Infants born to mothers with tuberculosis disease are at increased risk of developing tuberculosis disease themselves. We reviewed published studies and guidelines on the management of these infants to inform the development of a consensus practice guideline. We searched MEDLINE, CINAHL, and Cochrane Library from database inception to Dec 1, 2022, for original studies reporting the management and outcome of infants born to mothers with tuberculosis. Of the 521 published papers identified, only three met inclusion criteria and no evidence-based conclusions could be drawn from these studies, given their narrow scope, variable aims, descriptive nature, inconsistent data collection, and high attrition rates. We also assessed a collection of national and international guidelines to inform a consensus practice guideline developed by an international panel of experts from different epidemiological contexts. The 16 guidelines reviewed had consistent features to inform the expert consultation process. Two management algorithms were developed—one for infants born to mothers considered potentially infectious at the time of delivery and another for mothers not considered infectious at the time of delivery—with different guidance for high and low tuberculosis incidence settings. This systematic review and consensus practice guideline should facilitate more consistent clinical management, support the collection of better data, and encourage the development of more studies to improve evidence-based care.

中文翻译：

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结核病母亲所生婴儿的管理：系统评价和共识实践指南

患有结核病的母亲所生的婴儿本身患结核病的风险增加。我们回顾了已发表的有关这些婴儿管理的研究和指南，为制定共识实践指南提供信息。我们检索了 MEDLINE、CINAHL 和 Cochrane 图书馆（从数据库建立到 2022 年 12 月 1 日），寻找报告结核病母亲所生婴儿的管理和结果的原始研究。在确定的 521 篇已发表论文中，只有 3 篇符合纳入标准，而且由于这些研究范围狭窄、目标多变、描述性、数据收集不一致和高流失率，无法从这些研究中得出基于证据的结论。我们还评估了一系列国家和国际指南，为来自不同流行病学背景的国际专家小组制定的共识实践指南提供信息。审查的 16 条指南具有一致的特征，可为专家咨询过程提供信息。开发了两种管理算法——一种针对在分娩时被认为具有潜在传染性的母亲所生的婴儿，另一种针对在分娩时被认为不具有传染性的母亲所生的婴儿——针对高结核病发病率和低结核病发病率环境提供了不同的指导。这一系统回顾和共识实践指南应促进更加一致的临床管理，支持收集更好的数据，并鼓励开展更多研究以改善循证护理。